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Key points
- Experiencing severe, chronic adverse childhood experiences is related to violence, substance abuse, mental health, and suicide later in life.
- Negative outcomes of trauma are seen among those that experience discrimination, lack of resources, and failure of others to stop maltreatment.
- Trauma-informed services for children experiencing maltreatment are necessary for lifelong health.
The single victim and mass shootings have greatly increased in number in the first quarter of 2021 over prior years.
Suicide, violence, and substance abuse have increased among some sub-groups in the US. People are starting to increase face-to-face interactions following long periods of greater isolation during the pandemic. Trauma and lack of access to resources are part of the problem.
Emotional Crisis Without Support or Help
It is also important to understand that facing a major life crisis without help is also a primary characteristic of youth with severe and complex problems and those who commit mass murder. When someone is in crisis, services are necessary solutions to bad outcomes when people are in crisis with no resources to rely upon.
Access to services is disproportionally low in some rural and poor communities. Additionally, there are other incidences of disproportionality of services that we hear little about. Families who have children in a psychological crisis, but the parents/caregivers are unaware of resources or reluctant to get mental health, substance abuse, or trauma services for their children due to the stigma of these services. As a society, we must increase access to and destigmatize help for psychological or other immediate or chronic life crises.
Adverse Childhood Experiences
The CDC’s research on ACEs is detailed. Traumatized children who do not get adequate trauma-related care are more likely to have negative physical and mental health outcomes in adolescence and adulthood, including violence, suicide attempts, severe behavioral problems, mental health problems, substance abuse, delinquency, or criminality. The good news is that with effective trauma-informed care and additional services and supports, these youth can experience better life outcomes.
A large percentage of youth in our foster care system have experienced childhood trauma. Five children die every day from child abuse. Child abuse reports involved approximately 7.9 million children in 2019. Only 3.4 million maltreated children received prevention & post-response services. Children who experience child abuse and neglect are approximately 9 times more likely to become involved in criminal activity. Children that have been traumatized are 12 times more likely to attempt suicide.
Behavior Problems Related to Early Trauma
Additionally, a high percentage of youth expelled, suspended, or truant from school are identified as having “behavior problems” and experienced severe and chronic childhood trauma and maltreatment. Other sources of trauma include COVID 19 distress and discrimination against minority groups. Preventing trauma from occurring is one side of the equation and treating its physical and emotional outcomes is the other.
Trauma-Informed Care
Two kinds of services are needed for those in crisis and those with complex and chronic life difficulties. Those before the severe crisis occur (prevention) and services while the crisis occurs (intervention). Many of those in psychological crisis have experienced trauma as well. One of the answers for both prevention and intervention is trauma-informed care through increased services and supports. It is time to stop saying, “What is wrong with you” and start saying, “What happened to you” (Bounce Kentucky). Preventing and treating the outcomes of severe and repeated trauma is a place to start.
One solution to counteract the effects of trauma among youth is adequate access to trauma-informed care for any child who has experienced severe and/or chronic trauma. An assessment for childhood trauma can be found on the CDC.gov website and is called the ACE’s questionnaire. More than 5 ACE’s is associated with a higher frequency of unfortunate emotional, health, and physical outcomes for youth that experience trauma.
Trauma-Informed Model of Care
The following is a model for trauma-informed prevention and intervention for youth with a complex mix of problems related to mental health, substance abuse, family, trauma, maltreatment, juvenile services involvement, and school difficulties. The model includes:
1. Trauma-informed care including CBT and the ARC model of trauma treatment
2. Family therapy, services, and supports
4. Developmentally appropriate skill-building using the Behavioral Objective Sequence by Sheldon Braaten.
5. Evidence-based mental health and substance abuse services for youth with complex issues.
6. Trauma-informed care for all foster care youth, as well as those that have been frequently suspended, expelled, or truant from school.
7. Psychiatric Rehabilitation Services
8. Neurofeedback, biofeedback, and TMS
9. Yoga, exercise, grounding techniques, deep breathing, tapping, positive affirmations, and meditation
9. Working collaboratively with social services and juvenile services departments and physicians, social workers, psychiatrists, and schools to identify youth in need and ensure they and their families get the services and support they need.
Conclusion
Violence, substance abuse, some mental illnesses, and suicide can be treated and understood through the lens of untreated trauma. If we want to stop mass shootings, increased numbers of suicide, school failure, domestic violence, and domestic terrorism in America, we MUST identify the massive amount of childhood trauma in our country and provide excellent and effective supports and services for these traumatized youth.
